Milly, My Newest Hero

Several years ago I made a MySpace page and it asked me to list 'My Heroes.' I had to put some serious thought into who had been an inspiration in my life. I decided that Jesus didn't belong on this list of heroes because he is more than a hero to me. However, I did come up with a pretty long list of amazing people:

Mother Teresa - An example of the potential of humanity when we give up all our trivial and selfish pursuits and allow ourselves to merely be a channel of God's love to those around us.


(picture from google image search)


Dr. Paul Farmer - A passionate advocate for the health and well-being of the poor.

(Dr. Paul Farmer examining an AIDS patient. From Google image search)

Bono - I dislike his music and I know nothing of his personal life, but I think he is an example of how fame and fortune can be used to for good by directing attention to of the public to larger political issues concerning the developing world.

(Bono, speaking at the World Economic Forum as a proponent of canceling third world debt. From Google image search).

My College Professors - Often under appreciated and underpaid, they work tirelessly to teach students skills, such as writing, as well as how to discover answers to questions and larger issues on their own. By making a small difference in many people, they are making an essential improvement in the world.

My favorite professors at my, 'congratulations for getting into medical school party.' (However, I think that the above heroes category should also include all my other Skagit professors and my professors from the various universities I have attended).

My Mom - Also often under appreciated, she has dedicated her life to raising and educating her 13 children and helping them become the best people they can be.

My mom is in the middle of of this picture. The children in the picture are (from left to right, back row first): Paul (likes building Legos and writing science fiction), Peter (adopted from Russia and a really hard worker), Gene (adopted from Russia and a helpful boy who can make silly voices) , Sarah (can already cook apple crisp and happens to be a genius at math and science), Rachel (adopted from the US and a really good little helper who has been able to sing on pitch and harmonize since the age of 5), Monica (now 4 years old, she was adopted from Guatemala and has a lot of energy which she applies well in gymnastics class) and Anne (in a wheelchair and the sweetest little sister in the whole wide world). The children missing from the picture are: Aaron (physics genius, math genius, music genius, literature genius, spelling genius, and philosophy genius who also happens to be a really nice guy), myself (probably about to fail out of medical school), Kalkidan (adopted from Ethiopia and a really cute hard worker who pronounces English better than most Americans), Tadele (adopted from Ethiopia and soccer star), Berhanu (adopted from Ethiopia and soccer star), and Tesfaye (adopted from Ethiopia and soccer star). Uh, did I miss anyone?


After my trip to East Africa, I think I need to make an addition to my list of heroes:

Pastor Haffermann - Exhibiting many of the same qualities as Mother Teresa, he has dedicated the later years of his life to being an advocate for the Maasai people in central Tanzania.

(see blog entries in Feb and March)



Now, I would like to add another hero:

Milly - A very brave and kind woman who generously donated her body so that my 3 lab partners and I could learn anatomy from her.

Of course, Milly isn't her real name. Last week we decided that she seemed like a 'Milly' to us, so we named her. (I have noticed that students tend to give their cadavers nickname-ish type names or other names that demonstrate closeness such as 'Milly' or 'Betty.' I think this might be because we feel like we get to know our cadavers so well during the long hours we spend dissecting, that only a nickname seems fitting). All we really know about Milly is that she died when she was in her early 80's and her cause of death. I also know that Milly was somebody that cared about the world - even in her death she wanted to make the world a better place. It must have been a huge sacrifice for Milly to donate her body. Instead of her children being able to visit her grave where she would have been buried next to her husband, she lies in a room in the UW campus, slowly being cut apart each week by 4 students who really don't know what they are doing. She has no secrets before us. She was willing to do that for our education.

Tomorrow's Dissection Instructions

I don't have much time, but I thought I would share this with all of you:
__________________________________________________________

"Day 16: AM Oral Cavity and Nasal Sinuses:

...

II. Naso-Oropharynx in Sagittal View:
A. Using a hacksaw, divide the skull in the midline, completely separating nasal cavities, hard palate and soft palate. DO NOT divide the tongue. Start by sawing the skull through the midline of the frontal bone, keeping the saw level. If possible, try to saw just lateral to the nasal septum in order to keep it intact. Stop just after cutting through the hard palate. Cut the soft palate with a scalpel.

...

C. Superior meatus - Grasp the superoir concha with your thumb and forefinger. Elevate it medially fracturing the bone. What are the openings that you now see in the superior meatus?

...

D. Middle meatus - Similarly, facture the middle concha. Strip the mucous membrane and Identify and probe the opening with fishing line."

____________________________________________________________

The AM dissection instructions are 13 pages so I skipped a lot of stuff.

Lab is pretty intense and can be quite emotional.

The med school psych out game

Being in a low-key public health program and then traveling in East Africa, I have forgotten the intensity of some people who are intent on becoming physicians.

The other day I was sitting in my seat waiting for Anatomy class to start (which was to begin with a pre-class quiz). I couldn't help but overhear an animated conversation of several medical students behind me. They were discussing with confidence how they felt they were doing in the class. They were saying things like, "Yeah, man, this class is so easy!" and "Totally, I have barely studied and I have passed every quiz." and "Of course, everybody is going to pass the class - how could they not?" and "Yeah, I don't get much out of class - just on-line shop during lecture." (You get the idea).

Class started and the quiz (taken on a computer) was quite challenging. At the last minute I got confused and changed 2 correct answers to incorrect answers. When I got my score back at the end of the day it turns out that I failed the quiz. I was devastated. This is the second quiz out of the seven that I have failed.

The next day I was still discouraged and sat down to study with an individual that was in the group talking behind me the day before. She asked me how I was doing and I said that I was OK, but felt a little discourage because it seemed like everybody was doing better than me in the class. Then after a few moments, I confessed that I had failed the quiz the day before. She turned towards me and said quietly, "I haven't told anyone this, not even my lab partners, but I haven't passed a quiz yet." I was quite surprised at this since she had been acting so confident the day before. I had forgotten about the med school psych out game. sigh. maybe someday I will learn about the emotional complexities of medical school.

Avast, there!

FYI, It is International Talk Like a Pirate Day: http://en.wikipedia.org/wiki/Talk_Like_a_Pirate_Day
(just in case you were wondering what it was that was special about today).

Why it Has to be so Hard to Get into Medical School

Last night, while preparing for today's lecture and cadaver dissection, I had a revelation: I finally understand why it has to be so hard to get into medical school.

I think that medical school can be analogous to marrying a very difficult person who sucks all the life, time and money out of you, but has the potential of being a wonderful life-long partner.

First, you have the courtship period where you follow around other people who have married a similar difficult person many years ago. They acknowledge that the first few years of the marriage is difficult, but admittedly proclaim how wonderfully happy they are now. They dearly love and care for their spouse and feel they are making a difference in the world. They say that by being married to this person they are able to do so much more than they were alone. You are hooked. You begin to court this difficult individual. The privilege of becoming a life long partner to this person becomes your all-consuming desire. Your thoughts continually dwell on how you can show yourself to be a good enough person to marry this individual. You prepare yourself for years. When you finally think you are ready, you apply to the individual's family to ask for permission for the marriage.

Before the marriage, everybody says, "It is going to really suck marrying this person. Are you sure you want to do this? You aren't going to have time to do anything you used to enjoy. You aren't going to be able to spend time with your other friends and family. You won't be able to get enough sleep. You will question this decision again and again." You have to respond, "Yup, I am sure I want to marry this really difficult person." You have to write an essay telling why you want to marry this person. You describe how wonderful you think it will be once you go through the difficult time with this person and you finally get to the stage where you finally enjoy spending time with him/her. In your essay you might even describe some of your experiences spending time with people who have married a similar person many years ago. You have to have an interview with this person's parents and tell them how much you want to marry this person. How committed you are to making this relationship work. How you are willing to go into debt, have no time, and be completely miserable for a number of years to be with this person.

If you finally convince the individual's family/marriage approval committee that you will be a good spouse and that you can put up with this person, they give you approval for the marriage. When you get the approval you are so excited you can barely contain your joy. You almost forget that there are going to be many difficult years ahead before wonderful side of your partner predominates. The individual's family gives you pre-marriage orientation and tells you how bad it is going to be. They say oh, by the way, you won't have time for anything that you used to enjoy, but take care of yourself and stay healthy. Then they ask you to take your oath/marriage vows to be a good spouse to this person no matter what happens.

Then you enter into the difficult marriage. It is different for each person. However, for you it is even worse than the most horrible situation you imagined before the wedding day. Not only do you not get enough sleep and not have any time for other activities or friends, you are constantly worried about not being able to make the relationship work. You constantly doubt yourself – you worry that you won't be able to survive and make it to the good years of the relationship. Or you think that the difficult early years of the relationship will turn you into a different person who won’t be the kind of loving spouse that you wanted be to be once you reach the good years. To add on to all of that, this difficult person is spending all of your money! Unexpected costs come up everywhere and you have had to take out loans to keep this individual's financial appetite satisfied.

Why don't you give up on this taxing relationship? Just say, "Forget this!" Ask for a divorce, and go your separate ways. Oh, to bask in the joy of having time again, of not being stressed, of having a money again, of getting plenty of sleep every night. There are two things that stop you: First, you remember how badly you wanted to marry this person. You remember everything you had to go through to convince the individual's family that you were worthy of him/her. Secondly, you occasionally get a glimpse into what your relationship will be in the future. For a couple hours a week in your "Introduction to a Mature Relationship with a Difficult Person" course you experience what some of the potential of your relationship with this person. For those couple hours, everything seems to make sense. You realize how much good you can do in the world with this person once your relationship matures and you remember why you go through the daily struggle of surviving the relationship.

Just in case you all were wondering, the Introduction to a Mature Relationship with a Difficult Person course is really the Introduction to Clinical Medicine Course that we have every week. (I have written about it a little in earlier blog posts. It is supposed to develop our clinical skills and our listening, compassion and empathy towards patients. I think this class really offers a window into what medicine is suppose to be like while we are going through the horrors of medical school.

Stethoscope Ceremony

Today was the Family Day and Stethoscope Ceremony for the 2007 entering class at the UW medical school. It was really nice to meet every one's families and get my very first stethoscope. (My family couldn't make it because of the early morning time and the long drive down to Seattle. I jokingly adopted one of the faculty members who I met at orientation as a mom for the day. She was really sweet and funny and after the ceremony she came up and gave me a big hug and said, "Congratulations my adopted daughter for the day!"). The stethoscopes were paid for by the UWSOM Alumni Association. The expectation is that after we graduate and start working as physicians we will donate to the Alumni Association so they can buy stethoscopes and stuff like that for future classes. I felt a little bit bad because I will probably be working in Africa making next to nothing and won't be able to donate. Oh well, the stethoscope is nice though.

The only natural thing to do after getting your very own stethoscope on the fourth day of medical school is to pretend to be all doctorish and take a bunch of pictures with it. I have included some for your make-fun-of-student-doctor enjoyment:

Here is my stethoscope in its nice little box.

Here I am with my stethoscope around my neck. Do I look like someone you would be willing to trust with your health and medical decisions? Wait, don't answer that. (I wouldn't trust me with my health and medical decisions!)

Hmmm, do I actually have a heartbeat?

Greatest Hopes and Fears

We have this class which started the first day of fall quarter called, 'Introduction to Clinical Medicine' and it continues until our rotations (in the hospital) start in 3rd year. The purpose of the course is to get us comfortable with 'bedside teaching' - interviewing patients, learning compassion and communication skills, learning how to show empathy of our patients and to help us learn the physical exam.

The instructors for this 'ICM' course are awesome. They are funny, compassionate and very enthusiastic about teaching. All the older students say that this is one of the best and most enjoyable classes in the first two years. As our first assignments for this class we were supposed to write down our greatest hope and fear about becoming a physician. They compiled the list of everyone hopes and fears and it was a very inspirational experience to read through it. Everyone has very high hopes for their medical education. I decided to share a couple of them with all of you: :-)

I hope:

"to inspire my patients" (1st year medical student)

"I can develop relationships with my patients that help them feel safe, respected and understood" (1st year medical student)

"to complete the first year and still have my sanity at the end..." (1st year medical student

"that I will learn to truly listen" (1st year medical student)

"that many years from now when I am about to die, I can close my eyes and know that the world is a better place because I became a physician" (me)

"to make a difference in the lives of others, to make a difference in the way that health care is used and administered in this country" (1st year medical student)

I fear:

"that I don't really have what it takes to succeed..." (1st year medical student)

"hurting a patient due to ignorance or negligence" (1st year medical student)

"that I will harm a patient" (me)

"failing anatomy..." (1st year medical student)

"that I won't have enough time for the people I care most about" (1st year medical student)

"that I won't enjoy being a physician" (1st year medical student)

"that I may one day abandon the Marxist-Leninist ideals that led me to become a physician and instead use medicine to buy a big house and drive expensive cars, thereby turning into the gutless, spineless, and soulless peon of American corporate capitalism" (1st year medical student)

"that under the withering effects of cynicism and the tantalizing appeal of opportunity I'll lose sight of my primary goal to work with people who are without means to pay for health care under our current system" (1st year medical student)

These are our hopes and fears now. We will see if they are the same 4 years from now (assuming we all pass). Supposedly there is a general trend in medical school for students to loose their idealism and become cynical. I really hope that doesn't happen to me or my inspirational classmates.

My House in Seattle

Although my life has become exponentially less interesting since I have returned from Africa, I still find blogging to be a soothing release for my now very stressful life. Therefore I have decided to subject you all to some very boring blog entries about my mundane life.

Some of you asked about how I was able to find a house in Seattle really close to the UW campus while I was in Africa. It really was an answer to prayer.

During my work in Uganda I started emailing some girls who were renting out a room in a Seattle house. Everything looked good until they asked me to come by the next day and sign the lease and give a deposit check. I told them I was in Africa and asked if they could email me the lease, etc., but they decided I wasn't worth the effort and found someone else to rent the room. I was a little frustrated, and quite worried that I was going to come back to the states 3 weeks before med school started and not have anyplace to live. On my SLOW Ugandan internet connection I posted a housing request on the UW school of medicine housing board saying that I was an incoming med student who needed a place to live. I stated that I pretty quiet, fairly tidy, and wanted a specific price range, but most importantly I was currently in Africa and needed someone who was understanding of my situation.

The very same morning Kate and Melissa (two 3rd year medical students) decided they should rent out their spare 'study room' this year to save money and went on the UWSOM housing board. My housing request is the first one they saw and they immediately decided that I had to be the person who lived with them next year. (Kate did Peace corps in Zambia for 3 and half years and returned only 2 weeks before she started medical school so she knew exactly how I felt. Melissa had also travelled extensively). They emailed me and told me about the house - it was absolutely perfect. They were so nice, they saved the room for me and told me not to worry about the lease or the payment until I actually moved in.

The house is awesome. It is within walking distance of the UW school of medicine, is very clean and decorated with pictures and many wall-hangings from south eastern Africa. Kate and Melissa are also extremely friendly and fun to hang out with.


This is the door to Kate's room, immediately across the hall from my door. She bought this Giraffe wall hanging during her time in Zambia.

My room is fairly small, but has a huge walk-in closet. Kate suggested that I put my bed in the closet and then make a really nice study area with the rest of the room. She said only half-jokingly, "because you will spend more time studying than sleeping for the next 4 years!"

After looking at the space I decided she was right and so I put my bed in the closet. The closet looked a little bit like it was hit with the ugly stick (a magic stick that makes things ugly), so I decided to do my own version of, "Extremely Closet Make-Over, East African Addition."

The East African fabrics at the head of my bead in the now beautified ugly closet. The blue and black print is from the Maasai market in Morogoro, Tanzania, the red and black giraffe pillow case is from Malawi, and the white and orange scarfs (yes, I know, the orange doesn't match the red) are from Ethiopia.

The map, money and picture decorations at the foot of my bed. I bet you all didn't know that I am so rich I can affort to have 1,000s in bills taped on my wall! Just kidding. I am currently the defination of someone who is very poor. The bills on the wall from Uganda, Kenya, Tanzania and Malawi only total a couple of US dollars even though they are thousands of shillings.

Here is the 'nice study area' which is in my actual bedroom. Kate and Melissa were kind enough to leave the white board in the room f0r me to use. We have been learning the heart and the lung in Anatomy this week.

Some more of my room. I tried to cut my desk out of the picture because it had a pile of Anatomy books and study materials on it, but it didn't really work because you can still tell that my desk is really messy.

This is Melissa, my housemate. She is a 3rd year medical student at UW and is currently doing her internal medicine rotations. She is really nice. She is originally from Montana and is at UW through the WWAMI program. University of Washington is the only medical school for 5 states (Washington,Wyoming, Alaska, Montana and Idaho). WWAMI students do their first year of medical school in their home state and then come to the UW Seattle campus for 2nd, 3rd, and 4th year.

Living Anatomy

In 'Living Anatomy' we draw the position of internal organs on each other's skin. This is so we can know where an organ or other internal landmarks are in relation to the outside of a living person. Men usually take their shirts off and women usually just wear sports bras. I don't really enjoy the whole being-almost-topless-in-front-of-the-opposite-sex thing so I usually wear a white T-shirt. This is a picture of my shirt one day after living anatomy. The position of the heart, lungs and great vessels have been drawn out.

Human Anatomy in 6 Weeks = The Medical Student Hazing Ritual

The UW med school starts students off by teaching them all the anatomy of the head, neck, thorax and abdomen in 6 weeks. We have about 8 hours of class a day, a pre-class quiz or an oral presentation almost everyday and a huge pin and written test looming in our near future. Classes take the form of listening to someone speed through about a 100 lecture slides in 60 minutes and then dissecting a cadaver. There are 4 students to a cadaver. My lab partners are Ana, Aya, and Laura. (There were more women this year than men so there are some lab groups that are all female).

We have decided that compressing all first year anatomy into 6 weeks doesn't have any other practical purpose than to be a hazing ritual for new medical students to be accepted into the medical community. There is no way that we will remember all this anatomy and I don't think it is possible to be able to claim that cramming anatomy into 6 weeks will make us better doctors.

From Wikipedia: "Hazing is an often ritualistic test, which may constitute harassment, abuse or humiliation with requirements to perform random, often meaningless tasks, sometimes as a way of initiation into a social group." http://en.wikipedia.org/wiki/Hazing

Based on this definition, I believe that the anatomy in 6 weeks could be defined as hazing. 1) Compressed anatomy is ritualistic. Our professors had to do it, and their medical professors had to do it, and the medical students before them had to do it, so naturally they want to force us to do it. If I ever become a medical school professor, will I want to force my students to complete anatomy in 6 weeks? You bet! If I had to do it so should they. 2) OK, so maybe it is not abuse, but it is definitely humiliating to be put in a situation where you have trouble and you can't learn everything. 3) Yes, I would say this is an almost meaningless task because we probably won't remember anything. I will have to let you know in a couple years about this one. 4) Yes, it is definitely part of initiation into a social group. Are you convinced?

What the floor of my room often looks like when I am studying anatomy. At this point I am not sure if I will survive the intensive anatomy experience, but I hope to be fully accepted into the medical student community if I do.

An Apology to my Blog Readers about the Use of the Term "Africa"

I was recently contacted by a fellow medical student who went to Ghana this summer. She pointed out that I frequently use the blanket term of "Africa" in my blog which can lead to generalizations about the continent which is incredibly geographically and culturally diverse. This was not my intent and I hope that I have not led any of you to make generalizations about the entire African continent based on my experiences in East Africa. I have personally only visited: Tanzania (a little over 2 months), Uganda (2 and a half months), Kenya (2 months), Malawi (2 months in 2004), Ethiopia (only 1 day), and Zambia (only 3 days). Therefore, my experiences only let me explain and describe things as I see them in East and Southern Africa. I have never been to West Africa, North Africa or the majority of Central or Southern Africa. I am sure that I would be shocked at how different these other regions of Africa are from the countries I have visited.

So, the title of this blog should have been: Christy's Trip to Uganda, Kenya and Tanzania 2007

One again, I apologized and I hope that I have not led any of you to make generalizations about the African continent based on my experiences.

Thank you, Margaret, for the constructive criticism. I welcome additional comments if anyone else has found mistakes or oversights in this blog, please email me.